What ED People Got Wrong About Science with Dr. A'nna Roby
Have you ever considered what the limitations of scientific research are?
What do we do with the limitations in nutrition science? Much of the conversation among nutrition scientists, outside the realm of eating disorders, revolves around various fad diets or approaches involving highly processed foods, intermittent fasting, and keto diets, among other trends. But the majority of this evidence may lack comprehensive scientific support.
During this conversation, I want you to stay in the gray area with us.
In this episode, I’m talking with Dr. A’nna Roby. Dr. A'nna Roby is an esteemed physiologist, author, speaker, and Registered Dietitian specializing in disordered eating and eating disorders. She received her Bachelor of Science from Cornell University where she studied nutritional sciences. A'nna was then accepted to the combined PhD/Registered Dietitian position at Cornell where she did her dietetic internship and PhD simultaneously, focusing on metabolism and body weight regulation. After her doctoral training, A'nna moved to Washington, D.C. and conducted research at the National Institutes of Health. She now runs a private practice in the Minneapolis area helping individuals cultivate a healthy relationship with food and their body.
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Nutrition Science
Nutrition science is challenging to study due to the complexities of understanding what people eat. While other hard sciences can provide strong conclusions and progress quickly, nutrition faces unique obstacles.
Key Issues:
Assessing Dietary Habits: It is problematic to accurately evaluate individuals' eating patterns without inadvertently altering their behavior. Striking a balance between observation and intervention can be challenging.
Internal Validity vs. Real-World Applicability: Achieving internal validity, which ensures the certainty of results within a study, often entails tightly controlling all aspects of a participant's food intake within a controlled environment like a laboratory. However, this approach may not faithfully replicate real-world dietary behaviors.
Accuracy of Data Collection: Studying individuals' actual diets as they go about their daily lives, such as through food journals or self-reports, frequently introduces inaccuracies. These inaccuracies arise from human forgetfulness and the imprecision inherent in estimating portion sizes.
Isolating the effects of specific foods within the multifaceted context of a diverse diet is no small feat. This highlights the intricacies of nutrition research. Additionally, conducting large-scale studies in this field poses challenges and considerable expenses. Nutrition research often offers modest, incremental insights that, when pieced together, contribute to a larger, more comprehensive understanding.
There is a balance between skepticism and trust. Both play a pivotal role in evaluating nutrition research. While a critical eye is valuable, dismissing research entirely may lead to missed opportunities for knowledge. Focusing on broader patterns and consistencies within nutrition science can help us avoid getting lost in minor details.
Context Matters
Contextualizing nutrition information is vital. Understanding the unique circumstances of each individual is essential for healthcare professionals when tailoring advice. Embracing a more nuanced approach beyond the simplistic notion of "all foods fit" encourages a well-rounded and thoughtful discussion about nutrition, acknowledging that context matters greatly in this complex field.
Nutrition science is a continually evolving field with its share of complexities.
What is Intermittent Fasting?
Intermittent fasting is a buzzworthy topic in the world of nutrition. But what is it, really?
In a nutshell, intermittent fasting is an eating pattern that alternates between periods of fasting and periods of eating. Unlike traditional diets that focus on what you eat, intermittent fasting primarily emphasizes when you eat. It does not prescribe specific foods but rather establishes specific time frames for eating.
Gender Differences in Intermittent Fasting
Gender plays a significant role in how individuals respond to intermittent fasting. In women, the sympathetic nervous system, responsible for the body's fight-or-flight response, tends to become more active when practicing intermittent fasting. This heightened sympathetic response can lead to increased stress and anxiety, causing women to feel jittery and on edge during fasting periods. The physiological reaction may make intermittent fasting a less suitable dietary approach for women, given the associated stress levels.
Another critical aspect of gender differences in intermittent fasting pertains to its hormonal effects. The hormonal balance in women is particularly sensitive to dietary changes, and intermittent fasting can disrupt this equilibrium. Irregular menstrual cycles or, in severe cases, the cessation of menstruation, can occur when women adopt intermittent fasting practices. These hormonal disruptions are a cause for concern and underscore why intermittent fasting is not recommended for women seeking a sustainable and healthy eating pattern.
Considering the physiological responses and hormonal implications, it is important to emphasize that intermittent fasting is contraindicated for women. The potential health risks, including heightened stress levels and irregular menstrual cycles, outweigh any perceived benefits. Health professionals and nutrition experts typically advise against women engaging in intermittent fasting and suggest exploring alternative dietary strategies that are more conducive to their well-being.
Individual Responses
Despite there being gender differences in the response to intermittent fasting, it’s also not a one-size-fits-all approach, and individual responses can vary significantly. Factors like genetics, metabolism, and lifestyle play crucial roles in how individuals react to intermittent fasting regimens.
Engaging in overly restrictive fasting can lead to nutrient deficiencies, impacting overall health. It may also foster disordered eating behaviors, which can be detrimental in the long run.
The Importance of Consistent Meal Timing
Consistency is key. When you eat regular meals, spaced throughout the day, it contributes to a greater sense of satiety and satisfaction. By maintaining consistent eating schedules, you are less likely to experience extreme hunger or overeat during later meals. This approach promotes stable energy levels and better appetite control.
While consistent meal timing is beneficial, it's essential to strike a balance and avoid overly strict dietary rules that limit social engagement or flexibility in meal choices. The goal should be to establish a routine that aligns with personal preferences and daily schedules. Flexibility fosters a healthy relationship with food and maintaining both physical and social well-being.
The Circadian Rhythm Connection
First off - if you aren’t sure what the circadian rhythm is, it’s basically your internal biological system that regulates your physiological and behavioral processes. When individuals consume meals late at night, especially during their biological night, it can disrupt these circadian rhythms. This disruption can have significant implications for metabolic health, potentially leading to challenges in weight management (not that I care too much about that one) and overall well-being.
The effects of irregular eating patterns extend beyond intermittent fasting enthusiasts to include night shift workers who must align their meal schedules with unconventional hours. Night shift work can significantly affect metabolic biomarkers, leading to disruptions in insulin sensitivity, blood pressure regulation, and cortisol levels. So adopting an eating schedule to support your work shift is crucial.
The important piece here is that if you’re hungry at night, perhaps you’re not eating enough. Instead of arbitrarily saying to stop eating after a certain point, try rethinking your meals for the day.
Intermittent Fasting & ED History
As we have already established, intermittent fasting affects individuals differently based on their own genetics, past history, etc. That also goes for those who may have a history of an eating disorder. For anyone who is researching and hearing how “amazing” intermittent fasting is (it isn’t), it’s important to take into account several factors:
Triggers: Individuals in eating disorder recovery face complexity when considering intermittent fasting. It's a balance between curiosity and potential triggers.
Balancing Autonomy and Safety: We need to pay attention and find an equilibrium between personal autonomy and safety. This involves self-awareness, trigger recognition, and understanding the impact of restrictive eating on mental health.
Seeking Professional Guidance: Consulting healthcare professionals is the best option to seek out when things become too messy. They offer tailored advice, and progress monitoring, and ensure dietary choices support both physical health and mental well-being in the recovery journey.
In addition to gender differences, eating disorder history, genetic biomarkers, and personal preferences, there are a few other questionable things to point out with intermittent fasting:
Research conducted on animals regarding intermittent fasting may not be directly applicable to humans due to differences in lifespan and biology.
Some studies showed that monkeys on intermittent fasting lived longer but experienced overall poor health.
The trade-off between longevity and quality of life is a consideration.
Long-term studies on intermittent fasting in humans are lacking, making it difficult to draw conclusive results.
Intermittent fasting is a complex dietary practice that doesn't offer a one-size-fits-all solution. The evidence suggests that it may not be beneficial for everyone, particularly women who can experience hormonal and emotional challenges. Instead of adhering to strict fasting protocols, it's essential to prioritize self-care, consider individual responses, and consult with healthcare professionals when making dietary choices.
Remember, there's no substitute for a balanced, sustainable approach to nutrition that aligns with your unique needs and preferences.
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Tweetable Quotes
“There's all this hype about intermittent fasting and keto and what so many people were so quick to jump on is that it is terribly restrictive. It's it's horrible for you. But it's not that there's zero evidence.” - Rachelle Heinemann
“It's somewhat of a privilege problem. Some people don't have access to real food or the resources to prepare real food.” - Dr A’nna Roby
“We have shown that intermittent fasting is no better than a traditional diet in terms of weight loss. There's nothing magical about it.” - Dr A’nna Roby
“For those of you who are eating breakfast at seven and lunch at one, we're talking to you. Have a snack.” - Rachelle Heinemann
Resources
Dr. A’nna Roby’s Instagram - https://www.instagram.com/dr.annaroby/?igshid=MjEwN2IyYWYwYw%3D%3D
Dr. A’nna Roby’s Website - https://drannaroby.com/
Related Episodes
Episode 94. It’s not about the food, it’s about this.
Episode 82. Secrets and Eating Disorders with Dr. Kathryn Zerbe
Episode 78. Bone Health and Disordered Eating with Dr. Marci Goolsby
Episode 67. Is It All About Control?
Episode 60. Change Your Mindset, Change Your Life with Jen Diaz
Episode 54. When Intuitive Eating Isn’t The Answer with Laura Pumillo
More From Rachelle
Hey there! I’m Rachelle, the host of the Understanding Disordered Eating Podcast. As a Licensed Mental Health Counselor, I work with clients to make sense of life’s messy emotional experiences.
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